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Chemical Restraints

Indications
1. Dangerous and uncontrolled Violent Behavior
See Also
1. Physical Restraints
Dosing: Adults (lower doses in the elderly)
1. Haloperidol (Haldol): Preferred chemical restraint
  1. Haldol alone: 5-10 mg PO/IM/IV prn
  2. Haldol with Ativan q30 minutes prn (Mnemonic: B52)
    1. Haldol 5 mg
    2. Ativan 2 mg
  3. Haldol with Cogentin 1 mg
2. Droperidol (Inapsine)
  1. Inapsine (use with Cogentin 1 mg)
    1. Intravenous dose: 1.25 to 2.5 mg IV prn
    2. Intramuscular dose: 2.5 to 10 mg IM prn
  2. Adverse effects
    1. Very sedating
    2. May cause Orthostatic Hypotension
3. Lorazepam (Ativan) 1-2 IM/IV q6h prn
4. Midazolam (Versed) 5 mg IM prn
5. Fluphenazine (Prolixin) 5 mg IM q6h prn
6. Chlorpromazine (Thorazine) 50 mg IM q6h prn
7. Thiothixene (Navane) 5 mg PO or 10 mg IM prn
Dosing: Pediatric Dosing
1. Haloperidol (Haldol) 0.5 to 1 mg PO/IM/IV prn
2. Chlorpromazine (Thorazine) 0.25 mg/kg IM prn
Dosing: Adolescent Dosing
1. Haloperidol (Haldol) 1-5 mg PO/IM/IV prn
2. Chlorpromazine (Thorazine) 25 mg IM or 50-100 mg PO prn
3. Fluphenazine (Prolixin) 1-5 mg PO or 2-5 mg IM prn
4. Lorazepam (Ativan) 1-2 mg PO/IM q6h

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This page was written by Scott Moses, MD. This page was last revised before 5/10/08, prior to consistent tracking of revision date. This page was last published on 6/1/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.